From Demeter Press: The book focuses on doulas and the intimate practices involved with doula care. It raises critical questions about the social and cultural meanings of attending to women during the transition to motherhood. In her book The Tender Gift (1973), medical anthropologist Dana Raphael first applied the word doula to birth culture when describing the importance of “mothering the mother” and increasing successful breastfeeding results during the fourth trimester. Today the term doula covers a much broader field of birth work, which includes birth, postpartum and full spectrum doulas or doulas who care for women during abortion, adoption, surrogacy, miscarriage and stillbirth. This collection includes academic and personal essays written by a diverse group of scholars, including practicing midwives and doulas. This volume privileges the voices of doulas and researchers who study doulas, as we explore intimate labor, knowledge and the construction of different material realities of the birthing body. Contributing chapters focus on doulas as cultural brokers and translators during birth, doulas as mediators between birthing bodies and other care professionals such as labor and delivery nurses, the work of full spectrum doulas as birth activists working as abortion doulas, and the ways in which doulas negotiate the multiple identity transformations surrounding birthing bodies. As doulas negotiate their work, they represent a community in constant negotiation of borders and boundaries, one where we can turn as scholars to think through the process of birthing and what it means for the kind of work mothering entails.

And in a recent survey of more than 2,000 doulas, childbirth educators, and labor and delivery nurses across the U.S. and Canada, Louise Marie Roth, an associate professor of sociology at the University of Arizona, found that 63 percent of maternity support workers either “occasionally” or “often” witness a provider “engage in procedures without giving the woman a choice or time to consider,” and 17 percent report that providers go through with procedures even when they are explicitly against the wishes of a laboring woman.

“When you’re in the moment and things are urgent, it can be difficult to have the kind of comprehensive conversation that needs to happen to get really good, informed consent,” Roth told The Daily Beast.

Still, Roth stressed that a pregnancy doesn’t negate a woman’s civil rights. “There is no informed consent without informed refusal. If you can’t say ‘no’, then you don’t have informed consent.”

We are pleased that our research has been able to provide context to the story of Kimberly Turbin, from the perspective of “maternity support workers,” or the focus of our survey. We will continue to analyze the data exploring how often doulas, childbirth educators and labor & delivery nurses witness ethically troubling events in the course of providing care to birthing women in the U.S. and Canada. We will present our findings on this issue at the forthcoming annual meeting of the American Anthropological Association, November 18-21, Denver Colorado. The theme for the meeting is “Familiar/Strange.”

On some level, birth is familiar to us all – we were all born, and we have a general idea from personal experience, popular culture and for some, professional knowledge, how birth happens and what is the best way for birth to be socially organized. We can know, if we read the books and online postings, and the scientific literature, quite a bit about women’s experiences of childbirth. Yet we know little about the views of maternity workers, especially labor & delivery nurses, and how they compare to views of doulas or childbirth educators. What is familiar to a nurse is a strange world to the pregnant women and her family; childbirth educators and doulas attempt to be a conduit in making the strange familiar through their advance preparation classes and continuous presence at the birth, respectively. Our research tries to capture, through survey research methodology, how maternity support workers are similar to or different from each other in their views, and what factors might help account for their views.

by Jennifer Torres

Lactation consultants, who provide breastfeeding support, and doulas, who provide labor support, are two relatively new and rapidly growing groups working in maternity care. The work they do builds upon traditional forms of care that have existed for centuries – supporting women through the process of childbirth and the early days of caring for a new baby. However, these two groups perform this work as an occupation, where they are paid to provide these very intimate forms of care.

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Recently posted on Huffington Post Parents, this study highlights the relationship between C-section rates and the presence of a Doula.

“What our study showed is that [lower odds of a C-section] don’t come with wanting a doula; it’s having a doula that is actually associated with important and substantial risk reductions,” Kozhimannil said.

For the full story, follow the link below to the Huffington Post Parents site.

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Views of Doulas, Childbirth Educators and Labor and Delivery Nurses on Each Other, Emotional Burnout and Quality Improvement: Results from the Maternity Support Survey
Megan M. Henley and Christine H. Morton

This presentation provides an overview of results from the Maternity Support Survey, the first cross-national survey of doulas, childbirth educators, and labor and delivery nurses across the United States and Canada. Despite research on the benefits of supportive care during pregnancy, childbirth and postpartum, most researchers have explored how mothers and families view this care, with less attention to the views and experiences of individuals who provide such care (Liva et al. 2012; Morton & Clift, 2014). Similarly, research on maternity care providers has largely focused on midwives and obstetricians, neglecting the important roles of labor and delivery nurses, childbirth educators, and doulas (Monari et al. 2008; Morton & Clift, 2014; Reime et al. 2004; Smith et al. 2009). As a result, previous studies have not systematically studied or compared the practices and perceptions of workers who provide informational, emotional and physical support and advocacy to pregnant women. To address this gap in the literature, the Maternity Support Survey asked maternity support workers (doulas, childbirth educators, labor and delivery nurses) for their views on typical childbirth practices, their sense of efficacy in their maternity support roles, their orientation toward maternity support as a job or career, and their experiences with the American or Canadian health care system. This presentation is designed to inform learners of key findings from the Maternity Support Survey. These findings can increase participants’ knowledge of notable differences between these roles in terms of attitudes toward childbirth practices and toward other maternity support roles.

This study examined how doulas adapt to challenges in client’s labors. There were 104 Canadian and 92 American doulas who responded to a survey distributed at a doula conference. We report results from open-ended questions in which doulas describe how they manage changes deviating from the mother’s birth plan and how they navigate differences of opinion between themselves and providers. Four themes emerged: giving nonjudgmental support, assisting informed decision making, acting as a facilitator, and issues with advocacy. Although 30% of doulas said that advocacy and information giving could result in conflict with providers, doulas reported working within their scope of practice and striving to be part of the team. Issues in doula responsibility and patient advocacy remain, and ongoing role clarification is needed.

This recent article in the Journal of Perinatal Education focuses on how doulas help women adapt to unexpected changes in their birth plan during labor. The authors surveyed doulas attending a DONA International conference in Vancouver, Canada in 2008. In terms of interactions with care providers, the authors found that doulas acted according to the DONA International standard of practice.

According to the doulas surveyed, “support” does not mean supporting women through one set birth path, but supporting them through any turn labor may take and respecting the decisions of all others involved in the process. The Maternity Support Survey found that doulas were more likely than other support workers to have strong opinions about common labor practices such as epidurals, induction, and the use of Pitocin. Yet, the authors of this article found that doulas surveyed were able to put aside their personal opinions and focus on the desires of the women they serve.